[Bioregulatory drug Newrexan in the treatment of anxiety and dissomnia. Resolution of the Council of Experts (June 8, 2023)]. / Bioregulyatsionnyi preparat N'yureksan v lechenii trevozhnosti i dissomnii. Rezolyutsiya Soveta ekspertov (8 iyunya 2023 g.).

Bioregulatory drug Newrexan in the treatment of anxiety and dissomnia. Resolution of the Council of Experts.

[Neurological aspects of diagnosis and treatment of motor alalia]. / Nevrologicheskie aspekty diagnostiki i lecheniya motornoi alalii.

OBJECTIVE: To analyze the causes of violations of expressive speech in children 4-5 years old, to assess changes in neurological status in children with motor alalia without and during treatment with Cellex. MATERIAL AND METHODS: Two groups of patients were recruited: the main group (n=30; treatment; Cellex) and the control group (n=12; without Cellex). The drug was administered in the first half of the day by 1.0 ml subcutaneously, 10 days, daily. The patient's visit card was analyzed 4 times: before treatment, 10 days later, 1 and 2 months after the start of treatment. Statistical hypotheses were tested using the χ2 and Fisher criterions, the odds ratio (OR) and the 95% confidence interval (CI) OR were determined. RESULTS: In more than half of the cases, violations of the neurological status, the burden of the perinatal period, a decrease in cognitive tests, and a lack of fine motor skills were revealed. Left-handedness or two-handedness, overload of viewing or listening to gadgets from the age of up to a year, violations of opercular praxis were almost always noted. The effect of the drug Cellex on the «launch of speech¼ in children with motor alalia has been shown. It has been established that the drug is well tolerated, has no adverse side effects and has a positive effect on the «launch of speech¼. The progress of the dynamics of speech development, progress in play and cognitive activity was observed in all children of the main group. CONCLUSION: The use of the drug Cellex can be effective in the treatment of children with motor alalia.

[The biomarkers of cerebral ischemia as a new method for the validation of the efficacy of cytoprotective therapy]. / Biomarkery ishemii golovnogo mozga kak novyi metod dokazatel'stva éffektivnosti neirotsitoprotektorov.

AIM: To study blood plasma concentrations of NR2-peptide in patients with ischemic stroke (IS) to assess its diagnostic value as a biomarker of cerebral ischemia and determine the dynamics of the biomarker during treatment with cortexin. MATERIAL AND METHODS: One hundred and twenty patients, aged from 18 to 70 years, including 36 with transient ischemic attack (TIA) and 84 with IS in the carotid territory (n=70) and vertebral/basilar territory with the Wallenberg-Zakharchenko syndrome (n=14), were enrolled. The National Institute of Health Stroke scale (NIHSS) was used to assess neurological status. Blood plasma concentration of NR2-peptide was measured in all patients at admission and after treatment. All laboratory results were compared with neuroimaging (MRI, CT) data. RESULTS: Concentrations of NR2-peptide detected in all patients were higher than in controls (>1.5 ng/ml), p<0.0001. The direct correlation between NR2-peptide (from 3.38 ng/ml to 15.6 ng/ml) and ischemic lesion (from few to 80 mm) was observed. A decrease in NR2-peptide concentration (from 8.5 to 5,.9 ng/ml, p<0.0001) was noted in patients treated with cortexin after 10-day treatment course. CONCLUSION: NR2-peptide blood assay is a reliable hemotest of brain ischemia. Cortexin has a sufficient therapeutic efficacy.

[The improvement of treatment efficacy in newborn full-term infants with severe birth asphyxia]. / Povyshenie effektivnosti terapii novorozhdennykh donoshennykh detei s tyazheloi asfiksiei v rodakh.

AIM: To investigate the efficacy of cytoflavin as add-on to moderate controlled hypothermia in the treatment of newborn full-term infants with severe birth asphyxia. MATERIAL AND METHODS: Sixty full-term underweight children diagnosed with severe birth asphyxia (Apgar score 4-5) underwent moderate hypothermia for 72 hours. Depending on the regimen, the children were divided into two equal groups: the basic group received cytoflavin in dose of 2 ml/kg / day and the control group received the traditional scheme of therapy. RESULTS: The inclusion of cytoflavin increases the efficacy of therapy by reducing the severity of depression of consciousness (the increase in the average total score on the modified Glasgow Coma Scale pediatric/Saint Petersburg by 47.1% in children of the basic group compared with 27.9% in the control group, p=0.04) and more rapid recovery of vital functions (early extubation by 20.3%, p=0.03, and transition to enteral feeding earlier by 16.7% compared with the control group). The use of cytoflavin in newborns with severe asphyxia reduces lactic acidosis in the blood serum and normalizes EEG parameters as compared to the control group (p=0.02). CONCLUSION: Cytoflavin can be recommended as adjunctive therapy in full-term infants with severe intrapartum asphyxia.

[Intrathecal immunoglobulin production in the diagnosis and differential diagnosis of multiple sclerosis].

The evaluation of diagnostic significance of different immunological tests for intrathecal immunoglobulin production is summarized on the historical basis of investigation of patients with inflammatory, demyelinating and other neurological disorders. The assessment of cerebrospinal fluid lost its previous significance in the 2010 revision of diagnostic criteria for multiple sclerosis. Nowadays, it is used only for the diagnosis of primary progressive multiple sclerosis. Nevertheless, the requirements of the analysis of the cerebrospinal fluid are increasing due to subtle, subclinical and atypical cases of multiple sclerosis as well as undetermined demyelinating disorders. Intrathecal humoral immune response may be pathogenic in multiple sclerosis as suggest immunological data and effectiveness of anti-B cells treatment. Based on these tests, it is useful, to differentiate subgroups of patients and to evaluate different effects of treatment in perspective.

[Role and place of biochemical markers in diagnosis of cerebral ischemic stroke].

In recent years neurologists pay special attention to biochemical markers of instrumental diagnosis of brain ischemia in its acute phase. Determination of specific biomarkers in the blood of patients at early stages of cerebral blood circulation disorders may be helpful in screening patients at high risk of stroke in the short-term period. We present a review of literature and an analysis of own data (over 200 patients) with chronic and acute cerebral blood circulation disorders on the possibility of using brain biomarkers in clinical practice. The diagnostic value of NR2-antibodies in stroke with ischemic volume 5-70 cm3 is approximately 95,9% and in transitory ischemic attacks--98%.

[Influence of smoking on the cerebral hemodynamics and biochemical blood indices in chronic insufficiency of brain circulation]. / Vliianie kureniia na tserebral'nuiu gemodinamiku i biokhimicheskie pokazateli krovi pri khronicheskoi nedostatochnosti mozgovogo krovoobrashcheniia.

The influence of smoking on cerebral hemodynamics and biochemical blood indices has been studied in 50 male patients with chronic insufficiency of brain circulation (CIBC), aged 40-50 years, divided into 2 groups: smoking (n=26) and nonsmoking (n=24). Smoking was shown to play a substantial role in the development of discirculatory encephalopathy with atrophic brain changes, causing metabolic disturbances (a shift of acid-basic balance towards acidosis) and microcirculation disorders due to altered cerebrovascular reactivity. These alterations develop previously to hemodynamically significant atherosclerotic arteries lesion and emerge irrespective of the presence of atherosclerotic vascular changes, atherogenic shifts of lipid metabolism, disturbances of free-radical processes and platelet aggregation.

[Efficacy of cytoflavin in spondylogenic radiculomyeloischemia]. / Effektivnost' tsitoflavina pri spondilogennykh radikulomieloishemiiakh.

The efficacy of cytoflavin in the treatment of 60 patients (39 women, 21 men, age 32-64 year) with spondylogenic cervical and lumbosacral radiculomyeloischemia due to degenerative dystrophic spinal lesions was studied in a randomized double-blind placebo controlled study according to GCP rules. During 10 days 40 patients received intravenous cytoflavin dropper injections once daily; 20 patients (control group) received 5% glucose solution as a placebo. Considerable improvement was observed in 70% patients with radiculomyeloischemia of cervical localization and in 65%--with radiculomyeloischemia of lumbosacral segments. In the control group, positive dynamics of neurologic symptoms was 25-30% lower. Cytoflavin significantly reduced cognitive disturbances, improved reparative processes both in the central and peripheral neurons, and may be recommended in ischemic neuronal spinal lesions.